Initial Intake Form - Prospective Applicants (Canada)

Customer Details:
Full Name

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
Address

Street Address (Optional)

Street Address Line 2 (Optional)

CityState / Province

Postal / Zip CodeCountry
Which Category of Immigration to Canada are you interested in?
How old are you?
Ex: 36
What is your highest Academic qualification?
Do you have any Academic or Professional Designations?
Ex: # CPA / CFA / FRCPS etc.
Please tell us about your work experience
Ex: # of years, position, industry
Have you completed IELTS in the last 24 months?
Y/N, Will do (date), expected result
If you have completed IELTS, was it AC/GT and what were the individual scores?
ex: W:6, R:6, L:6: S:6, (GT)
If Married, tell us about your Spouse's academic background
Diploma / Bachelors degree / Masters /Professional degree/designations
If Married, tell us about whether your Spouse has done IELTS
ex: W:6, R:6, L6, S:6 (GT)
Do you have any relatives living in Canada as PR or Citizens?
Relatives must be either: Parents / children / siblings / uncles or aunts (not cousins)
Please tell us if you have previously studied / worked / lived in Canada?
Any other information you think may be relevant for us to know.
How did you hear about us?
Should be Empty:

Customer Details: